Provider Demographics
NPI:1376892125
Name:JAMA, SUAD AHMED (DDS)
Entity Type:Individual
Prefix:
First Name:SUAD
Middle Name:AHMED
Last Name:JAMA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 SEVEN OAKS PL
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3155
Mailing Address - Country:US
Mailing Address - Phone:571-278-2259
Mailing Address - Fax:
Practice Address - Street 1:9094 BELO GATE DR
Practice Address - Street 2:
Practice Address - City:MANASSAS PARK
Practice Address - State:VA
Practice Address - Zip Code:20111-7045
Practice Address - Country:US
Practice Address - Phone:571-278-2259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014164171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice